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Biomedical subjects

L Bellussi

Publications and source records attributed to L Bellussi.

At least 37 records · Page 2Linked to original sources
PubMed1999

Nasal allergy and atmospheric pollution.

Among the effects that pollution of the air causes on human health, irritation of the exposed mucosa is the earliest and the most obvious one. Pollutants damage the anatomical and functional integrity of the primary airways, in particular they cause alteration of the mucociliary system. The mucosa undergoing continuous aggression by an aerosol loaded with pollutants assumes the characteristics of a tissue with chronic inflammatory processes with dysepithelialised areas that could be an easy entrance for airborne allergens. The loss of integrity of epithelial lining, the interference with the repulsion of extraneous particles trapped in the mucus, the infiltration of the inflammatory cells and lymphocytes called into action by the phlogistic reaction multiply the occasion of meeting between environmental allergens and the immunological system of the host and basically of setting in motion the process of sensitisation. So there is a strict relationship between nasal allergy and pollution, that should not be ignored: allergy is the cause of considerable disturbances interfering with study, work and social activity and can lead to local and distal complications.

Air Pollutants↗
PubMed1999

Alterations of nasal mucociliary transport in patients with hypertrophy of the inferior turbinates, deviations of the nasal septum and chronic sinusitis.

Mucociliary transport (MCT) represents the first barrier of the nasal fossae and paranasal sinuses against various biological and physical insults. We studied the nasal MCT time using a mixture of vegetable charcoal powder and 3% saccharin in three groups of patients suffering from hypertrophy of the inferior turbinates, deviations of the nasal septum or chronic sinusitis. The mean values of the nasal MCT in the first two groups were practically identical to the normal ones. In contrast, significantly delayed times were found in patients with chronic sinusitis (P < 0.01). Findings indicate that this delay is determined by an increase in viscoelasticity of the mucus following the acute release of mediators of inflammation, together with a reduction in the periciliary stratum, which slows down the metachronous wave of the MCT.

Adolescent↗
PubMed1999

ABR evaluation of ototoxicity in cancer patients receiving cisplatin or carboplatin.

The development of ototoxicity was evaluated using auditory brainstem response (ABR) in cancer patients randomized to receive a cisplatin-based chemotherapy (cisplatin dose: 70 mg/m2) or a carboplatin-based chemotherapy (carboplatin dose: 250 mg/m2). The ABR measurements were performed in a sound-treated room using 2000 clicks of alternating polarity at an intensity of 100 dB PESPL presented to the patients at a rate of 21 clicks per second. Of 59 patients, 21 (9 in the cisplatin group and 12 in the carboplatin group) met our pre-established criteria and were included in the ototoxicity study. Two patients of the cisplatin group developed evidence of clinically occult ototoxicity after two cycles of chemotherapy; the latency of wave V of the ABR increased significantly from 5.874 to 6.336 msec and from 5.826 to 6.458 msec in both patients; these patients had a hearing loss detected by conventional audiometry (125 to 8,000 Hz) after five and six cycles of chemotherapy, respectively. None of the 12 examined carboplatin patients developed ABR-measured ototoxicity or abnormal audiograms during treatment. Our results suggest that ABR might prove to be useful in detecting early hearing deterioration from cisplatin.

Aged↗
PubMed1999

Treatment of hypertrophy of the inferior turbinate: long-term results in 382 patients randomly assigned to therapy.

A number of surgical techniques are commonly performed to control the symptoms of inferior turbinate hypertrophy unresponsive to medical treatment. We report long-term results in 382 patients randomly assigned to receive electrocautery (62), cryotherapy (58), laser cautery (54), submucosal resection without lateral displacement (69), submucosal resection with lateral displacement (94), and turbinectomy (45). Outcomes of objective test results from rhinomanometry, acoustic rhinometry, mucociliary transport time, and secretory immunoglobulin A levels were compared to the symptom scores before and yearly after surgical treatment. These data indicate that submucosal resection with lateral displacement of the inferior turbinate results in the greatest increases in airflow and nasal respiratory function with the lowest risk of long-term complications.

Adolescent↗
PubMed1998

[Comparative study of the effect of vasoconstrictive and balsamic agents in the decongestant nasal test].

The authors report a study of 60 subjects with mono or bilateral nasal obstruction of different etiologies (30 vasomotor rhinopathy, 30 septum deviations) evaluating the decongestion action of a vasoconstrictor. This substance for topic use was administered in pill form both in association with and without different balsamic substances. The patients underwent subjective evaluation using a visual analogy scale (VAS) and an objective test such as active anterior rhinomanometry (AAR) and acustic rhinometry (AR). All evaluations were performed under basal conditions and after the nasal decongestion test (NDT). The results were processed in order to evaluate: a) relationships between the subjective results (VAS) and the objective instrumental tests (AAR and AR); b) the mechanism by which the balsamic substances affect the symptoms. The purpose was to evaluate exactly how important balsamic substances are in topic vasoconstrictor preparations. Finally, an attempt was made to confirm the importance of the nasal decongestion test to provide a concise diagnostic picture and a suitable medical or surgical approach to "nasal obstruction" symptoms. Among other things, the results underline the importance of objective methods; thanks to their reliability they now provide an essential support in the surgical indications and in following-up every nasal obstruction treatment, even as regards forensic medicine. From a strictly pharmacological point of view, whether associated with balsamic substances or not, vasoconstrictors give similar results with all evaluation methods. On the other hand, the balsamic action is limited to a subjective sensation of increased nasal air flow stemming from the stimulation of cutaneous thermoreceptors in the vestibule. Although this sensation does not correspond to an objective reduction in nasal resistance, it cannot be neglected in the treatment of obstructive symptoms where the psychological component can play an important role.

Acoustics↗
PubMed1997

[Nasal surfactant: biochemical and histological study].

The existence of a Surface Tension Lower Substance (STLS) in the lung and the Eustachian tube was established a few decades ago. The histological and physiological characteristics of the epithelium of the whole respiratory tract, from the nasal cavities to rhinopharynx and bronchiolar segments, induced the Authors to search for such a similar substance also in nasal secretion. To this purpose nasal secretions were studied using High Pressure Liquid Chromatography (HPLC) to determine the presence of phospholipids. In addition, ultrastructural examination of the nasal mucosa was performed looking for lamellar body-like structures of 2nd degree pulmonary cells.

Humans↗
PubMed1997

Monitoring methods for local nasal immunotherapy.

When a patient is affected by specific vasomotor rhinopathy (allergic rhinitis), both perennial and seasonal, all the nasal functions are altered to various degrees. For this reason, in the evaluation of the efficacy of an antiallergic therapy we include: 1) anterior rhinoscopy; 2) active anterior rhinomanometry; 3) positioned acoustic rhinometry; 4) determination of mucociliary transport time; and 5) specific nasal provocation test. Active anterior rhinomanometry performed according to the directions of the International Committee on Standardization allows reliable assessment of the nasal respiratory function. Acoustic rhinometry is an objective method to assess the geometry of nasal cavities but, as a new method, needs more standardization with particular care in connecting the nose-piece to the nostril. Both these tests performed before and after local administration of nasal decongestants allow quantification of the congestion degree of the nasal mucosa. Determination of mucociliary transport time, according to the method of coloured tracer, is easy to perform and may be considered a reliable indicator of the mucosa eutrophism. In our clinical experience we have often found mucociliary transport times delayed or even blocked, especially in patients affected by perennial allergic rhinitis. According to our experience the specific nasal provocation test is one of the most important tests in this field: it is more sensitive than skin tests and RAST in the asymptomatic phase and it is able to show organ allergies. In this paper we review the importance of this test, the methodology we currently use as well as changes after local nasal immunotherapy.

Adolescent↗
PubMed1996

Acoustic rhinometry: practical aspects of measurement.

Rhinological diagnosis using acoustic rhinometry (AR) is described. The reliability of the test is improved by using a variable geometry craniostat allowing identical repositioning of the subject's head in various tests.

Adult↗
PubMed1996

[Longitudinal study on nasal polyposis: etiopathogenetic, clinical and therapeutic aspects].

The etiopathogenesis of nasal polyposis is yet uncertain; furthermore surgical treatment often is not able to completely resolve this problem, being recurrence very common. In our Clinic, we operated 647 patients for nasal polyposis, either by traditional surgical or endoscopy, in the last ten years. The aim of this study is to compare the results of different surgical techniques, considering the percentage of recurrence. We found that endoscopic surgery give better result than traditional one because it allows to see the place of origin of nasal polyps in the ethmoide. The follow-up was lasting between 1 and 10 years; during this time we administered a topical corticosteroide, to a group of patients, for 1 month; in a second group, we administered furosemide, a diuretic drug. According to our data, the percentage of recurrence in the group treated with furosemide was smaller than in other group treated with corticosteroide.

Adolescent↗
PubMed1996

Relapsing infective-phlogistic pathology of Waldeyer's ring and its relationship with secretory otitis media.

In our previous studies on the physiopathology of the rhinopharyngeal-tubal unit, we found and reported an unmistakable correspondence between rhinopathy and otitis media. However, we have often asked ourselves how and why severe cases of otitis media were often present in subjects without an evident obstructive naso-tubal pathology. With research that we have already published, we have been able to reveal how alteration of the ventilatory function of the tube is not the only factor that provokes affections of the middle ear. In our opinion, the phlogistic event is the main cause of otitis. Our conviction has recently been confirmed and strengthened by new research to which we wish to refer. A total of 92% of young patients and 65% of adult patients who underwent tonsillectomy in our Institute suffered from otitis media. These results emphasize that it is the infection, with the concomitant inflammation, that alters the function of the tube. Altered functions of drainage and defense cause affections of the middle ear in conditions of non altered ventilation and thus they are not documentable with the routine instrumental tests.

Adenoidectomy↗
PubMed1995

The rheological characteristics of nasal mucus in patients with rhinitis.

In this paper we have analyzed the physical properties of nasal mucus from 120 outpatients with rhinitis. We focused on the most relevant rheological features: viscosity, elasticity, adhesiveness, as well as ability to be spun ("spinability") or poured ("pourability"). A double-capillary type viscometer was used to measure viscosity and elasticity and the platinum ring method to measure adhesiveness. "Spinability" was measured with an automatic apparatus (Filancemetre Sefam) and "pourability" was determined by describing flow under gravity. Efficacy of nasal clearance was analyzed by measuring mucociliary transport time with an inert tracer using vegetal charcoal powder. Results showed that impaired nasal mucosal function in patients with rhinitis could be determined by studying rheological features in addition to measuring mucociliary activity. Information provided proved invaluable when considering possible treatment with agents affecting kinesis of nasal mucus.

Adhesiveness↗
PubMed1995

The adenoid as a key factor in upper airway infections.

The adenoids (and the nasopharynx) play a key role in the normal functioning and in various pathologies of the upper respiratory tract. In this paper the role of adenoidal pathology and the beneficial effect of adenoidectomy in some upper respiratory tract and facial anomalies and diseases are discussed; otitis media with effusion, recurrent acute otitis media, sinusitis, snoring and sleep apnea and abnormal patterns in the midface growth and development.

Adenoidectomy↗
PubMed1995

[Comparative study of most recent surgical techniques for the treatment of the hypertrophy of inferior turbinates].

The choice among the several techniques carried out to treat the hypertrophy of inferior turbinates is still difficult and matter of great interest. In the present study the Authors evaluated the efficacy and sequelae of the most common operations suitable for this pathology. The surgical procedures taken into consideration were (1) electrocautery; (2) cryotheraphy; (3) lasertherapy; (4) submucosal decongestion without lateral outfracture; (5) sub-mucosal decongestion with lateral outfracture; (6) turbinectomy. The six groups of patients (total 382) have been followed up for 4 years after surgery. At this aim the rhinomanometry, acoustic rhinometry, MCTt and SIgA dosage have been checked up together with the symptomatologic score. The conclusion was that the submucosal decongestion with lateral outfracture was the most effective technique for the chronic nasal obstruction, able to respect all the nasal functions.

Adolescent↗
PubMed1995

[Can the recurrence of nasal polyposis be prevented? A new therapeutic approach].

Nowadays nasal polyposis must be still considered an unsolved problem as the surgical procedures are unable to treat this pathology and the recurrence is very common. For this reason several Authors starting from the pathogenesis and the histological features have chosen a medical point of view at the aim of preventing the natural course of this disease. The present study experimented the effect of the furosemide locally administered in the prevention of polyps relapsing in subjects previously operated on. The Authors pointed out that the furosemide was able to decrease the nasal reactivity to the challenge with ultrasonic nebulized distilled water. Besides this drug locally administered for 3 months (once a day) maintained the nasal mucosa of the patients affected with hyperreactivity in a good functional condition without nasal obstruction. In fact no polyps were found at the objective examinations performed during the three years follow up and the values of acoustic rhinometry measurements were within the normal range. Finally the present research gave the opportunity to hypothesize the role of sodium, potassium and calcium ions transport regulated by drugs or other physiopathological events, in the physiology of the nasal mucosa.

Adolescent↗